Sponsoring Institution
National Institute of Food and Agriculture
Project Status
Funding Source
Reporting Frequency
Accession No.
Grant No.
Project No.
Proposal No.
Multistate No.
Program Code
Project Start Date
Sep 1, 2013
Project End Date
Aug 31, 2015
Grant Year
Project Director
Corbin, M.
Recipient Organization
Performing Department
Cooperative Extension Director
Non Technical Summary
What is the Issue: Seventy-five percent of United States health care spending is on chronic disease.The Appalachia region follows thespine of the Appalachia Mountains and has high rates of poverty, umemployment, limited access to healthcare, and behavioral health risks. Fifty-two percent of Pennsylvania counties are in Appalachia. Counties in the central area of the state are isolated and have limited healthcare services. In 2011,twenty-six percent ofthe state's population self-reported that they did not paricipate in physical activity in the last month and only, twenty-eight percent indicated they met the muscle strengthening guidelines in 2011. The top chronic diseases (heart disease and strokes, obesity, diabetes, breast cancer and osteoporosis)are all related to lifestyle factors in which physical activity is highly recommended.Why is this issue important: In rural PA, many older women live alone who need to be able to live as independently as possible. This is a critical concern when their health declines as their lives are shortened due to lack of healthcare and prevention practices. It is to their advantage to increase physical activity to increase muscle strength and flexiility, increasing the ability to do other physical activites on their own including work and to decrease health risks. Chronic health problems are on-going and have become more extremeas society has faced high health risks. People are living longer with serious health issues. On-going prevention health education in rural PA is sporadic. The focus on health in rural areas is on illness rather than on adequate early intervention and prevention. If the current trend is not stopped or reversed, rural PA will likely become more socio-economically depressed, affecting future generations.What is the program method: Extension educators and program site leaders will conduct a series of physical activity and nutrition education classes in ten rural counties with the goal of reaching 400 program participants. Extension will collaborate with community health partners who will refer patients to the program. Participants will receive support tomake appropriate lifestyle changes.How will program be evaluated: All participants will take pre and post fitness assessments and complete surveys about their food intake.What is the ultimate goal: The long term impact is that participants will increase their fitness level and strength, improve their nutrition, and decrease risk of osteoporosis; and therefore live independently longer, experience improved quality of life and decrease private health care costs.What societal benefits may be realized: Considering the escalating costs of health care, increased physical activity can reverse the physical changes related to aging and decrease risk of broken bones which costs about $9600 for five days of treatment. When rural communities lack health care providers and facilities, it is paramount that local residents do all they can to havea healthy lifestyle. When people are healthy, they can remain active in their community and will have a higher quality of life so they can contribute to the life of theircommunity, workand have an active life with their friends and family. Healthy people are less dependent on others for their care, transportation and needs.
Animal Health Component
Research Effort Categories

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
Goals / Objectives
Goal:To improve health factors through physical activity and nutrition education in rural Pennsylvania that will enable the participants to take greater responsibility for personal health.Objectives:1. By January 1, 2014, twenty site leaders/lay community healthy workerswill be identified by extension educators and trained who will facilitate participant training and communication.2. By January 1, 2014, extension educators will collaborate with CHP's for referrals and promoteincreased physical acrcity and healthy food choices among participants.3. By September 20, 2014, a total of twenty interactive educational classes for a total of 280-400 participants in ten county sites using the StrongWomen curriculum will be implemented.4. For each class session, extension educators and site leaders will conduct pre/post fitenss tests of all participants and have the participants complete five screening forms.5. By September, 2014, extension educators will develop twenty educational fact sheets for program use and submit to e-Xtension.
Project Methods
Twenty site leaders and their extension educator will be trained in a one day session. All components of the program will be covered including program management and delivery, general physical activity and benefits, medical history, clearances, exercise technique and nutrition.Community Health Partners will assist with identifying and recruiting participants, help with developing and marketing information, locating additional community support, implementation and follow-up.During the twelve week program, participants are taught in a group setting of two classes per week on nonconsecutive days about the effects of diet and exercise on bone and muscle health to attain and maintain peak bone mass. Classes are one hour and fifteen minutes.All participants will complete the Participant Summary Information Sheet, Medical History and Current Health Survey, Physical ActivityReadiness Questionnaire & You, IRB Participant Consent form and a Medical Information Release Form if over 70 years of age.All participants will take the Senior Fitness Test pre and post, The Strong Women Program Evaluation Survey, a social support scale. Scores will be compared and reports developed. All evaluation and data collection procedures are approved by Penn State's Institutional Review Board for Human Subjects. All data will be collected centrally.A three month follow-up booster session will be held to discuss and motivate for continued physical activity efforts. By the end of the project, new volunteer leaders will be identified.

Progress 09/01/13 to 08/31/15

Target Audience:359 participants,with an average age of62,enrolled in the StrongWomen program this past year from the following rural PA counties: Bradford, Centre, Clinton, Elk, Jefferson, Lycoming, McKean, Juniata/Mifflin, Northumberland, Tioga and Union. Thirty site leaders supported the program. The participants attended 22 StrongWomen classes that met twice a week for 1.25 hours persessionfor twelve weeks. In the class, they learned about how to adopt a healthier diet, how to properly perform the strength and weight bearing exercises and to how improve their balance and flexibility. Class members were enthusiastic and eager to learn all the weight bearing exercises and prepare healthier meals as a result of what they learned in the classes. Seventy-three percent indicated that they wanted to do something for themself and 95% wanted to improve their strength, flexibility and balance. 56% wanted to reduce their risk of osteoporosis. 60% wanted to improve their health such as blood pressure, cholestrerol, glucose level, bone density and lipids profile. 10% were referred by their doctor. Changes/Problems:Winter weather is usually a problem in being able to host extension classes in PA, so we usually set the classes to run from spring until early winter. Snow and ice occasionally inhibited the ability of the site leaders and the class members to get to their meeting sites. So, the goal is to set the fall classes so they end early enough that we don't run into weather issues. In some cases, it was difficult to recruit site leaders, so in one example,the extension educator and acommunity health interndrove 60 miles roundtrip, twice a week for 12 weeks to teach the classes. As a result 15 participants enrolled in the classes and two of the participants volunteered to become site leaders. Since the first session, the program has bewen successfully run for five series with over 100 participants. When the program began, recruitment of the target audience was a problem in some of the rural areasbut as the program became more well-known, most of the classes had a good attendance and we had moreindividuals wanting to be trained as site leaders. We used a variety of methods to advertise the program including newspaper ads, feature articles, exhibits, posters, word ofmouthand demonstrations. It was really important to advertise multiple ways to get the word out about the classes and to get people motivated to register for the program. The registration fee was an on-going concern so we lowered the fee or engaged volunteers to be leaders to be able to hold a class. We could therefore, at least, have participation versuslimited participation. In some rural communities, it was difficult to locate a meeting room that waslarge enough for the classes and that was available at a time convenient to offer the program. The extension educators were able to arrange workable space with various facilitiesso the classes weren't too crowded. In a few classes, class participants had a variety of life events happen to them that prevented them from completing the program or made their life challenging such as having a permanetly disabled/wheelchair bound spouse. It was disappointing when participants couldn't complete the program. What opportunities for training and professional development has the project provided?An initial training conducted in 2013 was provided by the StrongWoman Ambassador for the state oriented extension educators and new site leaders. The training featured informationon how to organize and manage the program. Additional site leader trainings wereheld:January 30, 2015, March 24, 2015, May 15, 2015 and August 20, 2015. How have the results been disseminated to communities of interest?The results will be shared with the Penn State Extension administration, extension educators, the localextension boards and CHP's. USDA will be informed of the results through this report and the Share your Science initiative at NIFA. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

What was accomplished under these goals? Research indicates that regular physical activity provides many benefits for a healthy lifestyle. Starting in their mid-forties, women begin to lose one-quarter to one-third pound of muscle each year and gain that much or more in fat. Lack of muscle tone and strength can complicate every day tasks, decrease balance and bone density and increase risk of falls. Osteoporosis robs women and some men of bone density with no outward signs. Eventually, even a minor stumble might fracture a hip. Twenty percent of patients who suffer from hip fractures will die as a result of complications. Regular weight-bearing exercise helps older women increase their strength, muscle mass and bone density, and decreases the risk of osteoporosis, diabetes, heart disease, arthritis, depression and obesity. Studies show that strength training helps combat weakness, frailty and debilitating consequences. Preventing the onset of osteoporosis is especially important. This project addressed the critical need in rural Pennsylvania of supporting older women who needed to reverse physical changes related to aging. Many rural communities lack facilties or locations where women feel comfortableattending a supervised physical activity program. This project worked to overcome barriers where the program had not been offered in the past andbrought together federally qualified critical access hopsitals and rural health clinics, extension educators and site leaders and the program participants in a new innovative way through the StrongWomen program. Through community education classes that met twice a week for twelve weeks, participants in nine countiesincorporated better nutrition and healthy activiites into their lives. Many participants reported that they: walked more, adopted a healthier diet of fruits, vegetables, fiber, whole grains, calcium, and vitamin D, and made a commitment to exercise. Six different tests are conducted in the senior fitness assessment: chair stand, two minute step test, sit and reach, back scratch, and 8' Up and Go test. In all cases, the post assessment scores were significantly higher than the pre-test scores indicating the program is effective in improving body strength and balance. Objective 1: Major activities: Thirty site leaders were trained with a face to face training in which they learned the mechanics of conducting the program. They received a training manual that included program delivery strategies; instruction on how to lead the strength training exercises and assessment tools to use to measure the participant's progress and program impacts. In many cases, theleaderswere recruited due to their involvement as a participant in the program.More site leader trainings were offered than originally intended as newleaders were interested in receiving the training.The training also served as a refresher for the extension educators. The site leaders were responsible for planning, promoting, and teaching the classes. Enthusiastic leaders were critical to helping the participants stay motivated to attend the classes. One participant expressed that she was very depressed after hip replacement surgery because she had limited range of motion despite physical therapy.With the StrongWomen program, she was able to walk up steps, stand on her feet all day at work and dance at her daughter's wedding.The StrongWomen program made a difference to her. Data collected: A registration form collected the leader'snames when they attended the training. All leaders became teachers of the program which allowed us to offer more program sites. Objective 2: Major activities:Extension educators collaborated withcommunity healthcare partnersto acquire participant referrals for the program. Some partners offered advertising and meeting spacesuch as the BrookvilleHospital, Bucktail Medical Center, Laurel Health System,and Two Sisters Wellness Center.Heathcare providers recommended their patients to the program. Data: Extension educators notified the PI if they were holding their classes in collaboration with a healthcare partner. Objective 3:Major activities:A total of17 classes were held the first year and22 classes were heldthe second yearfor a total of39educational classesin thirteen different locations which reached359 participants. The classes were delivered as a series of 24 classes, meeting twice weeking for 12 weeks, with classes typically lasting 60-75 minutes. The site leaders guided participants through simple, safe, and effective exercises using free and ankle weights. The site leaders also regularly facilitated discussions focusing on nutrition and health issues, usually based on extension fact sheets. Pre-test and post-test data were collected. Objective 4: Major activities: Pre/post fitness tests and screening forms were completed by the majority of participants. The tests and screening processwereused in allthe counties.The Senior Fitness Test,a valid and reliable tool,measured the functional fitness performance relative to muscle strength/endurance; aerobic endurance; flexibility and motor ability specifically power, speed/agility, and balance.Datawas collected on all participants and summarized. Specifically, participants improved their lower body strength which is very important for older adults to perform various basic tasks such as rising from a chair in a seated position unassisted, climbingstairs easily, and walking short distances. The improvement in upper body strength helps participants to complete household chores independently andincreases ability to take care of self and others and to move easily from one place toanother. Other tests demonstrated improved agility and balance while moving or abiltiy to maneuver more easily with low susceptibility to falling. Statistically significant improvements were made when comparing continuing participantsto first time participants in the following areas:improved general health, ease of doing everyday activities, increased flexibility, relief of joint pain, and improved balance and weight. Thirty percent (n=42) of first timersincreased their fruit and vegetable consumption. Forty-six percent (n=111) of continuing participants increased their fruit and vegetable consumption. Continuing participants are those individuals who attended additional classes after the first class series. Over 70% (n=168) consumed calcium and 30% (n=72)increased calcium intake and vitamin D. Twelve percent (n=30)of participants increased bone density basedupon Dexa Scan tests from doctor. Nine percent were able to decrease their medications.Over 60%(n=146)felt that they were considerably challenged to get the most benefit fromthe exercises.As a result of the StrongWomen program, 54% (n=128)ofthe participantshave begun participating inother types of physical activity such as yoga, aerobics and walking. Data on Social Surpport Scale:A benefit of the program was enhanced social environment conducive to the transfer of knowledge and skills.A Social Support Scale was also administered with all class members responding.84%enjoyed the social interaction they had with their group. 97% expressed that they would miss the members of their class when the session ended. Active participation by the class members resulted in self-efficacy and social support of others in the program which is especially meaningful in rural areas. Even though the StrongWomen program takes time to implement, the program has a positive reputation for stimulating individual and group commitment. Objective 5: Fifteen educational fact sheets were developed by a team of extension educatorswho supported the program and the fact sheetsare noted under Products. They will be submitted to e-Xtension.


  • Type: Other Status: Published Year Published: 2014 Citation: Campbell, D. Bone Mass Measurements: What the Numbers Mean. Penn State Extension, UK142.
  • Type: Other Status: Published Year Published: 2014 Citation: James, L. Organic Foods. Penn State Extension, EE0096.
  • Type: Other Status: Published Year Published: 2014 Citation: Roberts, A. and L. James. Rethink Your Drink. Penn State Extension, EE128.
  • Type: Other Status: Published Year Published: 2014 Citation: James, L. Vitamin E. Penn State Extension, UK148.
  • Type: Other Status: Published Year Published: 2013 Citation: Alloway, F. Gluten-Free Diets. Penn State Extension, EE0085.
  • Type: Other Status: Published Year Published: 2013 Citation: Alloway, F. Legumes. Penn State Extension, EE0086.
  • Type: Other Status: Published Year Published: 2015 Citation: Besecker, L. and L. James. Protein and Protein Supplements. Penn State Extension, EE0136.
  • Type: Other Status: Published Year Published: 2015 Citation: Henderson, L., and M. Corbin. Balance, Breathing and Flexibility. Penn State Extension, EE0143.
  • Type: Other Status: Published Year Published: 2015 Citation: Corbin, M. and L. Henderson. Warm-Up and Cool Down. Penn State Extension, EE0144.
  • Type: Other Status: Published Year Published: 2015 Citation: Besecker, L, and L. James. Sugar Substitutes. Penn State Extension, UK181.
  • Type: Other Status: Published Year Published: 2014 Citation: James, L. Omega Fatty Acids. Penn State Extension, UK143.
  • Type: Other Status: Published Year Published: 2014 Citation: Routch, N. Whole Grains, Healthy Grains. Penn State Extension, EE0136.
  • Type: Other Status: Published Year Published: 2013 Citation: Kaylegian, K. Yogurt: Active Nutrition for Active Lifestyles. Penn State Extension, EE0060.
  • Type: Other Status: Published Year Published: 2013 Citation: James, L., Motivators to Reach Your Health & Fitness Goals. Penn State Extension, UK170.
  • Type: Other Status: Published Year Published: 2013 Citation: Routch, N. Nuts about Nuts. Penn State Extension, EE0077.

Progress 09/01/13 to 08/31/14

Target Audience: 196 participants enrolled in the StrongWomen program this past year from the following rural PAcounties: Bradford, Centre, Clinton, Elk, Jefferson, Lycoming, McKean, Juniata/Mifflin, Northumberland, Tioga, andUnion. Twenty site leaders were trained for the program. Changes/Problems: The weather was a major challenge during the winter months of 2013-2014 which resulted in having to reschedule some of the sessions. Recruitment in rural areas was a challenge. At first the Clinton County extension educator struggled to recruit participants in the county, and she thought it was because StrongWomen was a new program and little was known about the benefits of strength training. Once she was able to get the programs up and running, many participants enjoyed it and wanted to be trained so the program could be continued. We have had a couple of site leaders resign for personnal reasons so we have worked at recruiting additional leaders to teach the program. Every community is different when it comes to knowing which type of advertising will work the best. The cost registration fee causes some partipants to hesitate to enroll. We have found that many people don't value orput a priority on their health. What opportunities for training and professional development has the project provided? Site leader training was held: October 22-23, 2013, January 31, 2014 and August 21, 2014. A booster training will be held October 31, 2014. How have the results been disseminated to communities of interest? The results will be shared with the Penn State extension administration, extension educators, the extension boardsand the CHP's. What do you plan to do during the next reporting period to accomplish the goals? Our goal is to continue to reach an additional 150 - 200participants during 2014-2015. We are striving to retain all participants who enroll into the program. With the opportunity to train additional site leaders, we will be able to host additional classes.

What was accomplished under these goals? Objective 1: Twenty sites leaders were trained and are qualified to offer the StrongWomen classes. In many cases, they were recruited due to their involvement as a participant in the program. The training also served as a refresher for the extension educators. Obective 2: Extension educators have collaborated with CHPS to acquire participantreferrals for the program. Some offered advertising and space for the classes including a hospital.The healthcare providers also helped recruit site leaders. Objective 3: A total of seventeen educational classes were held which reached 196 participants. Additional classes will be held for FY 2014-15 to reach additional participants. Objective 4: Pre/post fitness tests and screening forms were completed bythe majority ofparticipants. The tests and screening process are followed uniformally across the counties. Data is collected on all participants and summarized. Objective 5: Fact sheets were developed and will be posted on website this fall.